DYNAMIC NEUROMUSCULAR STABILIZATION
Dynamic neuromuscular stabilization (DNS) is a specific rehabilitative approach developed by Professor Pavel Kolar, a member of the well-known Prague School of Rehabilitation. DNS encompasses principles of developmental kinesiology during the first year of life - these principles define ideal posture, breathing patterns and functional joint centration. DNS treatment starts with the assessment and correction of breathing patterns and the client’s ability to create sufficient intraabdominal pressure (IAP). IAP is important because it stabilizes and decompresses the spine from the inside. To create adequate IAP, the client has to learn to use the diaphragm both as respiratory and postural muscle, but in order to do that a client must have proper posture, as the position of the spine, ribs and pelvis significantly affect the position and movement of diaphragm, and consequently the creation of proper IAP. After a client learns how to properly position the body parts, breathe and stabilize the core in different positions, movements and load are added to exercises. To move properly, a client must have proper core stabilization, but also proper joint centration. “Joint centration” refers to the ideal alignment of a joint where there is maximal contact between the bones in conjunction with a coordinated activity between stabilizing muscles. In DNS a great emphasis is placed on improving the ability to feel joint positions (proprioception) and to increase the control and awareness of movements.
Neurology plays an important role in the concept of DNS, with activation (facilitation) of the ideal movement programs stored in the brain as the main goal. A baby doesn’t have to be taught how to turn, crawl, sit and walk - correct movement patterns are already programmed in the baby’s brain. If the baby does not pass through all developmental processes correctly, dysfunctional patterns and postural disorders may develop. Dysfunctional patterns and movement impairments can also occur later in life, due to injuries, stress, poor postural habits, etc. To restore the correct “pre-wired” movement programs DNS utilizes many baby positions when evaluating and later activating the ideal stabilization and movement patterns in the adults.
DNS is used not only to prevent and treat pain syndromes, but also to enhance performance. Ideal posture, stabilization and joint centration maximize the efficiency of the movements, which not only reduces the risk of injury, but also improves performance.
BACKFIT PRO LOW BACK PAIN MANAGEMENT
Dr. Stuart McGill is a world-renowned expert in back pain, former professor of spine biomechanics at the University of Waterloo, and chief scientific officer of Backfitpro. For 30 years he has explored lower back mechanics and has authored hundreds of peer-reviewed scientific journal papers that address the issues of lumbar function, lower back injury mechanisms, tissue loading during rehabilitation, and the formulation of work-related injury avoidance strategies and high-performance training. Dr. McGill has worked with some of the best athletes in the world and his advice is often sought by governments, corporations, legal experts, medical groups, personal trainers and sports teams from around the world.
Dr. McGill has also published a couple of books and established courses that teach clinicians, trainers, coaches and performance specialists how the spine works and becomes injured / painful, by explaining anatomical, biomechanical and neurological aspects of the spine health. He also teaches how to perform and interpret provocative tests, how to identify aberrant motion and motor patterns and how to design and implement corrective exercise.
Dr. McGill is most famous for the “Big Three” nonnegotiable exercises he recommends, which are exercises that he found to be the most effective for gaining spine stability, while still sparing the spine. However, besides movement techniques which aim to empower the client to move without pain, he also explains training the back for performance (either athletic or occupational), which requires different approaches and objectives than training to fulfill rehabilitation objectives. The development of movement / motor patterns, endurance, speed, and power within the principles that minimize back injury, or exacerbation of existing injury are workshopped. Specific topics covered include building resilience, training capacity, and strength and speed techniques within pain-free progressions.
BLOOD FLOW RESTRICTION TRAINING
Blood Flow Restriction (BFR) training is a technique that combines low-intensity exercise with blood flow occlusion that produces similar results to high intensity training. It involves the application of a pneumatic cuff (tourniquet) proximally to the muscle that is being trained. The cuff is then inflated to a specific pressure with the aim of obtaining partial arterial and complete venous occlusion. The patient is then asked to perform resistance exercises at a low intensity of 20-30% of 1 repetition max (1RM), with high repetitions per set (15-30) and short rest intervals between sets (30 seconds). This enables an athlete to increase the size and strength of muscles with minimal joint / tissue stress, little to no soreness or delayed onset muscular soreness (DOMS) and little to no recovery needed.
PROPRIOCEPTIVE NEUROMUSCULAR FACILITATION
Proprioceptive neuromuscular facilitation (PNF), developed by Dr. Kabat in the 1940s, aims to promote functional movement through facilitation, inhibition, strengthening, and relaxation of muscle groups. The techniques use concentric, eccentric, and static muscle contractions. These muscle contractions, with properly graded resistance and suitable facilitatory procedures, are combined and adjusted to fit the needs of each client.
PNF is mostly known as a type of neuromuscular stretching technique, which uses the effects of autogenic and reciprocal inhibition (induced by static or concentric muscle contraction of adequate muscle) to achieve higher level of relaxation of a muscle, and an increased range of motion in the joint. However, PNF also contains other specific techniques that have the aim of increasing strength, joint stability, improving coordination and motor control, increasing endurance, or decreasing pain.
NEUROKINETIC THERAPY
https://neurokinetictherapy.com
NeuroKinetic Therapy (NKT) is a corrective movement system developed by David Weinstock. It uses specific muscle tests and protocols of testing to find out which muscles / tissues are neurologically overactive, and which are underactive. An appropriate release / stretch technique, followed by activation of underactive muscles are then used to reprogram the movement pattern stored in the region of the brain that’s responsible for learned motor control. According to NKT, massage and other myofascial release techniques help decrease the myofascial tension, but their effect is temporary. If the movement pattern is not reprogrammed, the dysfunction comes back.
To better understand how muscle imbalances cause muscle pattern compensations, joint dysfunctions, pain and injuries, it is necessary to understand the processes of reciprocal inhibition and synergistic dominance. When muscle A is overactive, tight and short, it causes decreased neural drive to a muscle B which performs the function opposite to the function performed by muscle A (functional antagonist). Muscle B then becomes underactive, and then muscles C, D, E etc., which perform similar functions to muscle B (synergists) have to work harder, to compensate for muscle B. Now these in turn become overactive, short and tight, and they “shut down” their functional antagonist, while their synergists become overactive. So the chain of muscle imbalances and compensations goes on, and a person may develop pain in the hip due to tightened lower leg muscles. As Karel Lewit from the Prague School of Rehabilitation once said, “He who treats the site of pain is often lost”. NKT helps a coach to diagnose where the dysfunction started, to find the cause of the problem, remove it, and reprogram the movement pattern.
PROPRIOCEPTIVE DEEP TENDON REFLEX THERAPY
P-DTR was developed by the orthopedic surgeon Dr. José Palomar. This approach recognizes that proprioception (the sensations of touch, pressure, hot, cold, pain, etc.), and the way the body processes the information from these receptors, is paramount in determining neuromuscular responses throughout the entire body. Motor function is not determined just by the motor system, but rather is modified by the inputs of these receptors. Using a comprehensive system of muscle testing and neural challenges, involved proprioceptors can be located and normal function can be quickly restored.